UAB selected for national breast-feeding program

UAB Hospital will work towards international "Baby-Friendly" designation.

UAB Hospital is the only hospital in Central and North Alabama, and one of three in the state, selected to participate in Best Fed Beginnings, a new national effort to significantly improve breast-feeding rates in states in which they are the lowest.

Although breast-feeding is one of the most effective preventive health measures for infants and mothers, half of babies born in the United States are given formula within the first week, and by age 9 months only 31 percent of babies are breast-fed.

According to the 2012 Centers for Disease Control and Prevention “Breastfeeding Report Card”, the rate for breast-feeding newborns in the United States was 76.9 percent — Alabama’s was 57.2 percent. Fewer than 25 percent of babies in Alabama are breast-fed at six months, and only 8 percent continue breast-feeding at one year, compared with 29.7 percent nationwide. Alabama is ahead of only Louisiana, Mississippi and West Virginia in breast-feeding rates.

Best Fed Beginnings seeks to reverse these trends by increasing the number of U.S. hospitals implementing a proven maternity services model that best supports a new mother’s choice to breast-feed. The National Initiative for Children’s Healthcare Quality is leading the effort through a cooperative funding agreement with the CDC and will be working closely with Baby-Friendly USA Inc. and selected hospitals to implement the initiative.

The American Academy of Pediatrics recommends babies be breast-fed exclusively for the first six months of life.

This designation verifies that a hospital has comprehensively implemented the WHO/UNICEF Baby-Friendly Hospital Initiative, which recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother-baby bonding. Breast-feeding rates are higher and disparities in these rates are virtually eliminated in hospitals that achieve this status.

The American Academy of Pediatrics, which has endorsed Ten Steps to Successful Breastfeeding outlined in the WHO/UNICEF Baby-Friendly Hospital Initiative, recommends babies be breast-fed exclusively for the first six months of life followed by continued breast-feeding as complementary foods are introduced, with continuation of breast-feeding for one year or longer as mutually desired by mother and infant.

Rune Toms, M.D., medical director of the UAB Regional Neonatal Intensive Care Unit and chair of the Alabama Breastfeeding Coalition education committee, says breast-feeding is important for the health of both mothers and babies. Breast milk provides optimal nutrition for babies, with a perfect concentration of carbohydrates, proteins, fats, minerals, vitamins and hormones. Breast milk also protects babies against infections and the mother provides valuable antibodies and other factors that help babies develop their own immune systems. For mothers, breast-feeding is associated with lower maternal risks of breast and ovarian cancer, Type 2 diabetes and postpartum depression. It also can be a great way to lose extra weight gained during the pregnancy.

For UAB’s patients and employees, breast-feeding has been a priority at the university, Toms says – even before this opportunity presented itself.

“UAB is a huge advocate in encouraging breast-feeding,” Toms says. "We already employ most of the steps set forth by the WHO/UNICEF Baby Friendly Hospital guidelines. We have a written policy supportive of breast-feeding, and our goal is to feed term babies breast milk within the first hour of life. Further, we provide private areas within the hospital and around campus where mothers can feel comfortable breast-feeding. We also provide full support from our staff — all of our nurses are certified breast-feeding educators — and we have internationally board-certified lactation consultants on staff to support for nursing mothers."

In addition, August is National Breastfeeding Awareness Month, and as part of its kickoff for the Best Fed Beginning initiative UAB is hosting discussions with health-care providers and patients to identify preferred ways to educate mothers about infant feedings. Knowing the best ways to approach and teach expectant and new parents about the importance of breast-feeding is one of the keys to increasing the number of breast-fed babies.

“The UAB Innovation Board’s funding of our infant-feeding focus groups is a reflection of the commitment UAB has to reaching out to the community to identify and meet our patients’ needs in creative ways,” Edwards says. “The community focus groups are a collaborative effort engaging partners from the various UAB Obstetrics and Gynecology clinics, UAB School of Health Professions, Jefferson County WIC Office and Healthy Start.

Bottom line, Toms says, is that breast-feeding is fundamental to good health, but too often is dismissed.

“We need more education programs at birth facilities and in community health services. There need to be more community nurses and lactation consultants available in these settings to help nursing mothers. There also need to be more community breast-feeding groups created to provide nursing mothers peers to assist and support them,” Toms says. “And, there needs to be acceptance of breast-feeding breaks in the workplace and private locations in workplaces and in public places to accommodate breast-feeding mothers. When these things are accomplished, I believe the number of women breast-feeding their children at least six months will grow.”

Following hip fracture increases after a reduction in reimbursement rates for DXA scans led to fewer scans, a UAB physician joined other advocates and successfully lobbied to increase DXA scan reimbursements to better identify and reduce hip fractures.

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